Vitiligo seems
to be more common in people with certain autoimmune diseases
(diseases in which a person's immune system reacts against
the body's own organs or tissues). These autoimmune diseases
include hyperthyroidism (an overactive thyroid gland),
adrenocortical insufficiency (the adrenal gland does not
produce enough of the hormone called corticosteroid),
alopecia areata (patches of baldness), and pernicious anemia
(a low level of red blood cells caused by failure of the
body to absorb vitamin B-12). Scientists do not know the
reason for the association between vitiligo and these
autoimmune diseases. However, most people with vitiligo have
no other autoimmune disease.

Vitiligo may
also be hereditary, that is, it can run in families.
Children whose parents have the disorder are more likely to
develop vitiligo. However, most children will not get
vitiligo even if a parent has it, and most people with
vitiligo do not have a family history of the disorder.

What
Are the Symptoms of Vitiligo?

People who
develop vitiligo usually first notice white patches (depigmentation)
on their skin. These patches are more common in sun-exposed
areas, including the hands, feet, arms, face, and lips.
Other common areas for white patches to appear are the
armpits and groin and around the mouth, eyes, nostrils,
navel, and genitals.

Vitiligo
generally appears in one of three patterns. In one pattern
(focal pattern), the depigmentation is limited to one or
only a few areas. Some people develop depigmented patches on
only one side of their bodies (segmental pattern). But for
most people who have vitiligo, depigmentation occurs on
different parts of the body (generalized pattern). In
addition to white patches on the skin, people with vitiligo
may have premature graying of the scalp hair, eyelashes,
eyebrows, and beard. People with dark skin may notice a loss
of color inside their mouths.

Will
the Depigmented Patches Spread?

There is no
way to predict if vitiligo will spread. For some people, the
depigmented patches do not spread. The disorder is usually
progressive, however, and over time the white patches will
spread to other areas of the body. For some people, vitiligo
spreads slowly, over many years. For other people, spreading
occurs rapidly. Some people have reported additional
depigmentation following periods of physical or emotional
stress.

How
Is Vitiligo Diagnosed?

If a doctor
suspects that a person has vitiligo, he or she usually
begins by asking the person about his or her medical
history. Important factors in a person's medical history are
a family history of vitiligo; a rash, sunburn, or other skin
trauma at the site of vitiligo 2 to 3 months before
depigmentation started; stress or physical illness; and
premature (before age 35) graying of the hair. In addition,
the doctor will need to know whether the patient or anyone
in the patient's family has had any autoimmune diseases and
whether the patient is very sensitive to the sun. The doctor
will then examine the patient to rule out other medical
problems. The doctor may take a small sample (biopsy) of the
affected skin. He or she may also take a blood sample to
check the blood-cell count and thyroid function. For some
patients, the doctor may recommend an eye examination to
check for uveitis (inflammation of part of the eye). A blood
test to look for the presence of antinuclear antibodies (a
type of autoantibody) may also be done. This test helps
determine if the patient has another autoimmune disease.

How
Can People Cope With the Emotional and Psychological Aspects
of Vitiligo?

The change in
appearance caused by vitiligo can affect a person's
emotional and psychological well-being and may create
difficulty in getting or keeping a job. People with this
disorder can experience emotional stress, particularly if
vitiligo develops on visible areas of the body, such as the
face, hands, arms, feet, or on the genitals. Adolescents,
who are often particularly concerned about their appearance,
can be devastated by widespread vitiligo. Some people who
have vitiligo feel embarrassed, ashamed, depressed, or
worried about how others will react.

Several
strategies can help a person cope with vitiligo. First, it
is important to find a doctor who is knowledgeable about
vitiligo and takes the disorder seriously. The doctor should
also be a good listener and be able to provide emotional
support. Patients need to let their doctors know if they are
feeling depressed because doctors and other mental health
professionals can help people deal with depression. Patients
should also learn as much as possible about the disorder and
treatment choices so that they can participate in making
important decisions about medical care.

Talking with
other people who have vitiligo may also help a person cope.
The National Vitiligo Foundation can provide information
about vitiligo and refer people to local chapters that have
support groups of patients, families, and physicians. Family
and friends are another source of support.

Some people
with vitiligo have found that cosmetics that cover the white
patches improve their appearance and help them feel better
about themselves. A person may need to experiment with
several brands of concealing cosmetics before finding the
product that works best.

What
Treatment Options Are Available?

The goal of
treating vitiligo is to restore the function of the skin and
to improve the patient's appearance. Therapy for vitiligo
takes a long time--it usually must be continued for 6 to 18
months. The choice of therapy depends on the number of white
patches and how widespread they are and on the patient's
preference for treatment. Each patient responds differently
to therapy, and a particular treatment may not work for
everyone. Current treatment options for vitiligo include
medical, surgical, and adjunctive therapies (therapies that
can be used along with surgical or medical treatments).

This site
is not intended to give medical advice. Seek the advice of
a professional for diagnosis, medication, treatment options,
and complete knowledge of any illness. The opinions
expressed here are exclusively my personal opinions do not
necessarily reflect my peers or professional affiliates. The
information here does not reflect professional advice and is
not intended to supersede the professional advice of others.